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P02.64. Vitamin D sufficiency is necessary for integrative treatment-associated improvements in chronic pain status


To examine the relationship between improved vitamin D status and reported severity of chronic pain.


Prospective observational study over 12 weeks of 252 patients with pain of any source lasting more than 6 months who sought integrative medicine evaluation and treatment at one of 9 Bravenet clinical sites across the United States. Interventions were not mandated. Baseline vitamin D status was reported to each clinician. Treatment options included conventional therapies as well as acupuncture, nutrition, massage and mind-body skills training. Measurements included the Brief Pain Inventory and 25-OH-vitamin D status.


A total of 252 adults met eligibility criteria. Mean 25-OH-vitamin D levels and standard deviations at the start and 12 weeks later for all participants were 33.43 (17.05) and 39.58 (16.29). (p <0.0001). The subset of low back pain patients demonstrated similar values of 32.71 (14.34) increasing after 12 weeks to 39.19 (13.26) (p <0.0001). Of all participants, 153 (60.7%) achieved 25-OH-vitamin D levels above the 2010 international recommendation of ≥ 30 ng/ml and 99 (39.3%) did not. Of all 136 back pain participants, 90 (66.2%) achieved levels ≥ 30 ng/ml and 46 (33.8%) did not. Median average pain scores decreased from 5 to 4 during the study. Regardless of the integrative therapies applied, achievement of a serum level ≥ 30 ng/ml was necessary for significant improvement in average pain (p =0.0018 for all patients, p =0.022 for all back pain).


Chronic pain patients who sought integrative medicine demonstrated a high incidence of vitamin D deficiency. In the setting of additional treatments, serum levels ≥ 30 ng/ml were required for significant improvement in average pain scores. Failure to achieve a serum level ≥ 30 ng/ml represents a confounder of any therapeutic intervention in both clinical practice and clinical trials for chronic pain including chronic low back pain.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Plotnikoff, G., Dusek, J. & BraveNet Practice Based Research Network. P02.64. Vitamin D sufficiency is necessary for integrative treatment-associated improvements in chronic pain status. BMC Complement Altern Med 12 (Suppl 1), P120 (2012).

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